The global community is continuing to feel the far-reaching ramifications of the HIV/AIDS epidemic. Over a quarter of a century into the epidemic, Vital Voices is taking a closer look at the devastating affects of the disease and the international response to curb the tide that is sweeping across the globe. Recent statistics suggest that the world’s response has been insufficient to successfully challenge the enormity of the HIV/AIDS pandemic. In particular, Vital Voices feels that the “feminization” of HIV/AIDS has not been properly addressed within the international community. Indeed, the epidemic is demonstrating rapid infection rates among women and girls, especially those aged 15-24. In part, the spread of HIV/AIDS among women is closely intertwined with the violation of women’s rights. Vital Voices proposes four approaches in order to effectively fight the spread of HIV/AIDS: strengthening political will, ensuring gender equality, building civil society capacity and engaging the business community.

“Women are the backbone of society. Keeping women healthy is not just the right thing to do; it’s the smart thing to do. If there’s one place in this epidemic to intervene, one place where our efforts will yield dramatic results, this is it. The truth is empowering women andgirls to protect themselves and their familiiesfrom AIDS is keyto turning this tide.”

- Dr. Peter Piot, Executive Director of UNAIDS and Under Secretary-General of the United Nations, 2006

HIV/AIDS: A Global Epidemic

• 26 years after the first AIDS diagnosis was made in 1981, the international community has witnessed numerous success stories in curbing the tide of this global epidemic. However, as the most recent statistics suggest, we are losing the war against HIV/AIDS
• The number of people living with HIV has soared since the discovery of the disease. In 1990, approximately 8 million people were diagnosed with HIV. At the end of 2005, nearly 40 million people had been infected with HIV according to Avert. The global increase of people living with HIV/AIDS has skyrocketed by 80% in the past 15 years (Source: http://www.avert.org/worldstats.htm)
• In 2006, Dr. Peter Piot, the Executive Director of UNAIDS acknowledged that every single day 8,000 people die from AIDS and 14,000 women and men become infected – every single day (Source: http://data.unaids.org/pub/SpeechEXD/2006/20060307_SP_Piot_GeorgetownUniversity_en.pdf)

How serious is this global challenge?

• From 2004 to 2006, an additional 2.6 million adults and children were living with HIV according to the UNAIDS 2006 AIDS Epidemic Update (Source: http://data.unaids.org/pub/EpiReport/2006/2006_EpiUpdate_en.pdf)
• The UNAIDS/WHO 2006 Global Report on the AIDS Epidemic reveals startling estimates about the development of HIV/AIDS globally:
  • 38.6 million people worldwide were living with HIV in 2005
  • 4.1 million became newly infected with HIV
  • 2.8 million lost their lives to AIDS
• The same report estimates that in 2005, 26% of infants born to HIV-infected mothers were also infected (Source: http://www.unaids.org/en/HIV_data/2006GlobalReport/default.asp)

Increasing prevalence among women

• The overall growth of the HIV/AIDS epidemic has been especially aggressive among women. In every region of the world, the spread of HIV among women and girls aged 15+ has increased.
• In the United States, the proportion of women among new HIV or AIDS diagnoses has increased dramatically. According to a 2007 Kaiser Family Foundation report, in 1985 women represented only 8% of AIDS diagnoses; by 2005 they accounted for 27% (Source: http://www.kff.org/hivaids/upload/6092-04.pdf)
• In sub-Saharan Africa, nearly three out of four (74%) of young people aged 15-24 years living with HIV are female according to The Global Coalition on Women and AIDS
• http://data.unaids.org/pub/GlobalReport/2006/2006_GR_CH02_en.pdf
• UNFPA reports that in 2005 an estimated 6,000 young people in this age range become infected every day (Source: http://www.unfpa.org/swp/2005/presskit/factsheets/facts_youth.htm)
• Globally, young women and girls represent over 60% of all 15-24 year olds living with HIV according to a 2006 UNAIDS report (Source: http://data.unaids.org/pub/Report/2006/20060807_Universal%20Access_TheNextSteps_en.pdf)
• If the number of cases remains consistent, over 1.31 million young women will contract HIV over the course of a year

Violation of women’s rights contributes to the spread of HIV/AIDS

• Women are more susceptible to contracting HIV/AIDS even without leading a life of risk-associated behavior (sexually promiscuity, injecting drug, use, etc.). According to The Global Coalition on Women and AIDS, evidence suggests that marriage can be a major HIV risk factor for women, especially young women and girls. (Source: http://data.unaids.org/pub/Booklet/2006/20060530_FS_Keeping_Promise_en.pdf)
• Violations against women’s rights contribute to the spread of HIV/AIDS. Harmful practices include:
• Violence against women
  • The Global Coalition on Women and AIDS recognizes the growing links between violence against women and HIV. HIV infected women are more likely to have experienced violence and that women who have experienced violence are at a higher risk for HIV. (Source: http://womenandaids.unaids.org/issues_violence.html)
• Human Trafficking
  • In a compounded violation against women’s human rights, human trafficking amplifies the risk and stigma associated to women by subjecting them to HIV/AIDS infection as well as the ongoing trauma of their situation:
    • A study conducted by Banerjee, Sengupta, Singh, and Pal concluded that in addition to the initial trauma and violence associated with being trafficked, women forced to be sex workers also face societal violence, psychological and economic violence. “Over 87% of the respondents reported being physically threatened and 70% reported being physically assaulted. 48% reported physical injury, 56% reported being raped and 18% reported being gang raped.”
    • The risk of acquiring HIV/AIDS is much higher for women who experience violence in the sex industry
    • Women who are trafficked into sex work have an undeniably higher risk of contracting HIV/AIDS due to their inability to negotiate for the use of condoms
• Early marriages
• Worldwide, 82 million girls marry prior to turning 18 and increase their risk of becoming infected with HIV/AIDS due to the diverse sexual encounters of the older men that are financially capable of marrying these young girls according to the Confronting the Crisis report issued by UNFPA. (Source: http://www.unfpa.org/publications/index.cfm?ID=190)

Vital Voices’ Approaches to Stop HIV/AIDS

Vital Voices proposes four approaches to effectively fight the spread of HIV/AIDS

Strengthening Political Will

• Internationally, countries must join together in action to meet the objective set forth by 189 states through the Millennium Development Goals to halt and reduce the number of HIV infections by the year 2015.
• Domestically, governments should emulate successful initiatives in order to curb the rate of infection
• Governments should progressively pursue policies to diminish the risks that specifically threatens the lives of women: increase primary and secondary education for girls, legislate and enforce policies to end violence against women, proactively work towards ending human trafficking, and protect girls under the age of 18 from early marriages

Ensuring Gender Equality

• In 2006 , UNAIDS reported that in fewer than 10% of the 79 countries surveyed do women participate fully in the development of national AIDS plans
• The active engagement of women is integral to effectively promote:
  • The creation of institutions and programs tailored to the needs of women
  • Forms of birth control to empower a woman’s choice
  • The reduction of stigma and discrimination levied against women with HIV/AIDS

Building Civil Society Capacity

• Empowering civil society helps in the fight against HIV/AIDS by:
  • Reducing the stigma and discrimination as public awareness rises
  • Provides a support network for HIV-positive people
  • As individual NGOs and leaders unite behind the cause of HIV/AIDS, they increase the likelihood of effectively lobbying government policies to reflect the needs of civil society
• Select governments are attempting to crush HIV/AIDS activism and the NGOs that represent the cause
• However, as a Dr. Piot has acknowledged, civil society engagement is essential for all countries in successfully fighting the AIDS epidemic

Engaging the Business Community

• It is time for more businesses to take up the challenge in fighting the HIV/AIDS epidemic
• Corporations can proactively pursue policies that provide demonstrative results when actively engaged within communities:
  • Raise awareness of their staff and throughout the community about HIV/AIDS, oftentimes working with NGOs to increase the reach of their message
  • Train the staffs of small and medium enterprises in order to conduct educational awareness meetings
  • Offer to provide medical assistance in states where universal treatment is not available